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Review
. 2021 Dec;7(12):1487-1492.
doi: 10.1016/j.jacep.2021.07.012. Epub 2021 Sep 29.

Radiation-Induced Changes in Ventricular Myocardium After Stereotactic Body Radiotherapy for Recurrent Ventricular Tachycardia

Josef Kautzner  1 , Kristina Jedlickova  2 , Marek Sramko  3 , Petr Peichl  3 , Jakub Cvek  4 , Lukas Knybel Ing  4 , Radek Neuwirth  5 , Otakar Jiravsky  5 , Ludek Voska  2 , Tomas Kucera  6
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Free article
Review

Radiation-Induced Changes in Ventricular Myocardium After Stereotactic Body Radiotherapy for Recurrent Ventricular Tachycardia

Josef Kautzner et al. JACC Clin Electrophysiol. 2021 Dec.
Free article

Abstract

Stereotactic body radiotherapy (SBRT) has been suggested as a promising therapeutic alternative in cases of failed catheter ablation for recurrent ventricular tachycardias (VTs) in patients with structural heart disease. This case series is the first postmortem immunohistochemical analysis of morphologic changes in the myocardium early and late after SBRT. The present findings are in line with experimental observations on apoptosis followed by fibrosis. This may explain why the effect of SBRT on VT is not predominantly immediate. Together with observation of early recurrences after SBRT for VT, these data suggest that this strategy may have rather delayed antiarrhythmic effects.

Keywords: catheter ablation; histology; immunohistochemistry; radiotherapy; ventricular tachycardia.

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Conflict of interest statement

Funding Support and Author Disclosures This work was supported by grant project AZV NU20-02-00244 from the Ministry of Health of the Czech Republic and by funding from the European Union’s Horizon 2020 research and innovation program under grant agreement 945119. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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